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[PMID]:28460281
[Au] Autor:Simonsen C; Faerden A; Romm KL; Berg AO; Bjella T; Sundet K; Ueland T; Andreassen O; Melle I
[Ad] Endereço:NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Postbox 4959 Nydalen, 0424 Oslo, Norway. Electronic address: c.e.simonsen@medisin.uio.no.
[Ti] Título:Early clinical recovery in first-episode psychosis: Symptomatic remission and its correlates at 1-year follow-up.
[So] Source:Psychiatry Res;254:118-125, 2017 Aug.
[Is] ISSN:1872-7123
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:The aim was to gain more knowledge about early clinical recovery in first-episode psychosis (FEP). The interrelationship between symptomatic remission, poor global functioning and neurocognitive impairment was investigated. FEP participants (n =91) from the TOP study were investigated at baseline and 1-year follow-up. Symptomatic remission was defined by internationally standardized criteria. Poor global functioning was defined as GAF-F score ≤60. Neurocognitive impairment was defined as 1.5 standard deviation below healthy controls on a neuropsychological composite score. Finally, early clinical recovery was defined as symptomatic remission during the last 6 months and functional remission (1. GAF-F score ≥61, 2. at least 50% study/employment, and 3. living independently). At 1-year follow-up 26% were in symptomatic remission, predicted by duration of untreated psychosis and baseline positive symptoms. Significantly fewer in the symptomatic remission group had poor global functioning compared to the non-remission group, with no difference in the rate of neurocognitive impairment. Finally, 14% were considered in early clinical recovery. They had the same rate of neurocognitive impairment as the remaining group. These findings imply that symptomatic remission and early clinical recovery can already be identified at 1-year follow-up, and that this is relatively independent of neurocognitive impairment.
[Mh] Termos MeSH primário: Transtornos Psicóticos/diagnóstico
Transtornos Psicóticos/psicologia
Recuperação de Função Fisiológica
Esquizofrenia/diagnóstico
Psicologia do Esquizofrênico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Sintomas Comportamentais
Feminino
Seguimentos
Seres Humanos
Masculino
Testes Neuropsicológicos
Recuperação de Função Fisiológica/fisiologia
Indução de Remissão
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


  2 / 2151 MEDLINE  
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[PMID]:29202529
[Au] Autor:Zhang LL; Wang Y; Cheng Y; Zhang N
[Ti] Título:[Characteristics of cognitive function, behavioral and psychological symptoms in patients with Alzheimer's disease versus behavioral variant frontotemporal dementia].
[So] Source:Zhonghua Nei Ke Za Zhi;56(12):903-908, 2017 Dec 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To compare the differences in cognitive function and behavioral and psychological symptoms between patients with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Thirty-six AD patients and 20 bvFTD patients at mild-to-moderate stage, who were biomarker-confirmed by positron emission tomography (PET), were assessed with a neuropsychological battery and neuropsychiatry inventory (NPI). Cognitive domains, including memory, language, information processing speed and executive function, and behavioral and psychological symptoms were assessed and compared. AD patients had lower scores in immediate recall, delayed recall and recognition than bvFTD patients (all 0.05); while bvFTD patients had poorer performance in language and executive function than AD patients (all 0.05). The NPI total score was significantly higher in patients with bvFTD compared with patients with AD (17.5±5.7 vs 9.3±3.5, 0.05). In respect to the 12 items of NPI, the incidence of agitation and irritability was higher in AD group than in bvFTD group (72.2% vs 35.0%, 55.6% vs 20.0%, all 0.05); while the incidence of apathy, disinhibition, euphoria, aberrant motor behavior and appetite/eating was higher in bvFTD group than in AD group (65.0% vs 33.3%, 80.0% vs 5.5%, 70.0% vs 5.6%, 40.0% vs 11.1%, 50.0% vs 5.6%, all 0.05). Comprehensive neuropsychological assessment and evaluation of behavioral and psychological symptoms of patients with dementia are helpful in distinguishing AD from bvFTD.
[Mh] Termos MeSH primário: Doença de Alzheimer/diagnóstico por imagem
Sintomas Comportamentais/etiologia
Transtornos Cognitivos/diagnóstico
Cognição/fisiologia
Lobo Frontal/patologia
Demência Frontotemporal/diagnóstico por imagem
Testes Neuropsicológicos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Doença de Alzheimer/diagnóstico
Biomarcadores/metabolismo
Análise Discriminante
Feminino
Seres Humanos
Masculino
Memória/fisiologia
Meia-Idade
Tomografia por Emissão de Pósitrons
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2017.12.003


  3 / 2151 MEDLINE  
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[PMID]:28470485
[Au] Autor:Sudol K; Mann JJ
[Ad] Endereço:Frank H. Netter MD School of Medicine, Quinnipiac University, 370 Bassett Road, North Haven, CT, 06473, USA.
[Ti] Título:Biomarkers of Suicide Attempt Behavior: Towards a Biological Model of Risk.
[So] Source:Curr Psychiatry Rep;19(6):31, 2017 Jun.
[Is] ISSN:1535-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF REVIEW: The rising suicide rate in the USA will not be reversed without improved risk assessment and prevention practices. To date, the best method for clinicians to assess a patient's risk for suicide is screening for past suicide attempts in the patient and their family. However, neuroimaging, genomic, and biochemical studies have generated a body of findings that allow description of an initial heuristic biological model for suicidal behavior that may have predictive value. RECENT FINDINGS: We review studies from the past 3 years examining potential biological predictors of suicide attempt behavior. We divide findings into two major categories: (1) structural and functional brain imaging findings and (2) biochemical and genomic findings encompassing several systems, including major neurotransmitters (serotonin, catecholamines, GABA, and glutamate), the hypothalamic pituitary adrenal (HPA) axis, the inflammasome, lipids, and neuroplasticity. The biomarkers that appear promising for assessing suicide risk in clinical settings include indices of serotonergic function, inflammation, neuronal plasticity, and lipids.
[Mh] Termos MeSH primário: Sintomas Comportamentais
Neuroimagem Funcional/métodos
Neurotransmissores/metabolismo
Medição de Risco/métodos
Tentativa de Suicídio
[Mh] Termos MeSH secundário: Sintomas Comportamentais/genética
Sintomas Comportamentais/metabolismo
Sintomas Comportamentais/fisiopatologia
Biomarcadores/metabolismo
Predisposição Genética para Doença
Seres Humanos
Sistema Hipotálamo-Hipofisário/fisiologia
Modelos Biológicos
Plasticidade Neuronal/fisiologia
Sistema Hipófise-Suprarrenal/fisiologia
Tentativa de Suicídio/prevenção & controle
Tentativa de Suicídio/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers); 0 (Neurotransmitter Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1007/s11920-017-0781-y


  4 / 2151 MEDLINE  
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[PMID]:28459953
[Au] Autor:Mac Donald CL; Barber J; Jordan M; Johnson AM; Dikmen S; Fann JR; Temkin N
[Ad] Endereço:Department of Neurological Surgery, University of Washington, Seattle.
[Ti] Título:Early Clinical Predictors of 5-Year Outcome After Concussive Blast Traumatic Brain Injury.
[So] Source:JAMA Neurol;74(7):821-829, 2017 Jul 01.
[Is] ISSN:2168-6157
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The long-term clinical effects of wartime traumatic brain injuries (TBIs), most of which are mild, remain incompletely described. Current medical disability cost estimates from world conflicts continually surpass projections. Additional information regarding long-term functional trajectory is needed to reduce this extensive public health burden. Objectives: To examine 5-year clinical outcomes leveraging existing clinical data collected at 1 year after injury in the same patients and to identify early risk factors for long-term disability. Design, Setting, and Participants: This prospective, longitudinal study enrolled active-duty US military after concussive blast injury (n = 50) in the acute to subacute stage and combat-deployed control individuals (n = 44) in Afghanistan or after medical evacuation to Germany from November 1, 2008, through July 1, 2013. One- and 5-year clinical evaluations were completed in the United States. All concussive blast injuries met the Department of Defense definition of mild, uncomplicated TBI. In-person clinical evaluations included standardized evaluations for neurobehavior, neuropsychological performance, and mental health burden that were essentially identical to the evaluations completed at 1-year follow-up. Data were analyzed from October 1 through November 30, 2016. Main Outcomes and Measures: Changes in the in-person standardized evaluations for neurobehavior, neuropsychological performance, and mental health burden from the 1- to 5-year follow-up. Predictive modeling was used to identify early risk factors for long-term disability. Results: Among the 94 participants (87 men [93%] and 7 women [7%]; mean [SD] age, 34 [8] years), global disability, satisfaction with life, neurobehavioral symptom severity, psychiatric symptom severity, and sleep impairment were significantly worse in patients with concussive blast TBI compared with combat-deployed controls, whereas performance on cognitive measures was no different between groups at the 5-year evaluation. Logistic regression on the dichotomized Extended Glasgow Outcome Scale (GOS-E) at 5 years as a measure of overall disability identified brain injury diagnosis, preinjury intelligence, motor strength, verbal fluency, and neurobehavioral symptom severity at 1 year as risk factors for a poor outcome at 5 years, with an area under the curve of 0.92 indicating excellent prediction strength. Thirty-six of 50 patients with concussive blast TBI (72%) had a decline in the GOS-E from the 1- to 5-year evaluations, in contrast with only 5 of 44 combat-deployed controls (11%). Worsening of symptoms in concussive blast TBI was also observed on measures of posttraumatic stress disorder and depression. Service members with concussive blast TBI experienced evolution, not resolution, of symptoms from the 1- to 5-year outcomes. Conclusions and Relevance: Considerable decline was observed in military service members with concussive blast TBI when comparing 1- and 5-year clinical outcomes. These results advocate for new treatment strategies to combat the long-term and extremely costly effect of these wartime injuries.
[Mh] Termos MeSH primário: Sintomas Comportamentais/etiologia
Traumatismos por Explosões/complicações
Concussão Encefálica/complicações
Disfunção Cognitiva/etiologia
Escala de Resultado de Glasgow
Transtornos de Enxaqueca/etiologia
Militares
Avaliação de Resultados (Cuidados de Saúde)
[Mh] Termos MeSH secundário: Adulto
Campanha Afegã de 2001-
Estudos de Casos e Controles
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Prognóstico
Fatores de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171218
[Lr] Data última revisão:
171218
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1001/jamaneurol.2017.0143


  5 / 2151 MEDLINE  
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[PMID]:28427396
[Au] Autor:Auer S; Linsmayer E; Beránková A; Pascher P; Firlinger B; Prischl D; Ratajczak P; Span E; Holmerova I
[Ad] Endereço:Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria. Stefanie.Auer@mas.or.at.
[Ti] Título:DEMDATA: The Austrian-Czech institutional long term care project - design and protocol of a two-centre cross sectional study.
[So] Source:BMC Health Serv Res;17(1):296, 2017 Apr 20.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The organization of long-term care is one of the main challenges of public health and health policies in Europe and worldwide, especially in terms of care concepts for people with dementia. In Austria and the Czech Republic the majority of elderly institutionalized persons with dementia are cared for in nursing homes. It is however unclear, how many persons living in nursing homes in Austria and in the Czech Republic are suffering from cognitive impairment and dementia. In addition, basic information on the nutritional status, the status of mobility and the medication prescription patterns are often missing. To facilitate new effective and evidenced based care concepts, basic epidemiological data are in urgent need. Thus, DEMDATA was initiated to provide important basic data on persons living in nursing homes in Austria and the Czech Republic for future care planning. METHODS: DEMDATA is a multicentre mixed methods cross-sectional study. Stratified and randomly drawn nursing homes in Austria and the Czech Republic are surveyed. The study protocol used in both study centres assesses four different domains: a) Resident, b) Care team, c) Relative and d) Environmental Factors. Resident's data include among others health status, cognition, dementia, mobility, nutrition, behavioural symptoms, pain intensity and quality of life. A minimum of 500 residents per country are included into the study (N = 1000 residents). The care team is asked about the use of the person-centred care and their burden. The relatives are asked about the number of visits and proxy-rate the quality of life of their family member. All staff employed in the nursing homes, all residents and relatives can voluntary take part in the study. The environmental factors include among others the organisational category of the nursing home, number of residents, number of rooms, social activities and the care concept. The project started in March 2016 and will be concluded in February 2018. DISCUSSION: DEMDATA will provide important epidemiological data on four different nursing home domains in Austria and the Czech Republic, with a focus on the prevalence of dementia in this population. Thereby supplying decision and policy makers with important foundation for future care planning.
[Mh] Termos MeSH primário: Demência/terapia
Assistência de Longa Duração/organização & administração
[Mh] Termos MeSH secundário: Idoso
Áustria/epidemiologia
Sintomas Comportamentais/psicologia
Sintomas Comportamentais/terapia
Transtornos Cognitivos/psicologia
Transtornos Cognitivos/terapia
Estudos Transversais
República Tcheca/epidemiologia
Demência/epidemiologia
Demência/psicologia
Família/psicologia
Feminino
Instituição de Longa Permanência para Idosos/estatística & dados numéricos
Seres Humanos
Institucionalização
Masculino
Casas de Saúde/estatística & dados numéricos
Assistência Centrada no Paciente
Médicos/estatística & dados numéricos
Qualidade de Vida
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2244-x


  6 / 2151 MEDLINE  
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[PMID]:28378724
[Au] Autor:Ovcharenko SI; Volel' BA; Galetskaite YK
[Ad] Endereço:I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
[Ti] Título:[A personalized approach to the pulmonary rehabilitation of patients with chronic obstructive pulmonary disease].
[Ti] Título:Personalizirovannyi podkhod k legochnoi reabilitatsii bol'nykh khronicheskoi obstruktivnoi bolezn'yu legkikh..
[So] Source:Ter Arkh;89(3):18-23, 2017.
[Is] ISSN:0040-3660
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To elaborate and introduce personalized pulmonary rehabilitation (PR) programs adapted in terms of the types of disease response in patients with chronic obstructive pulmonary disease (COPD) and to evaluate the effectiveness of the programs. SUBJECTS AND METHODS: A total of 85 patients with COPD of more than 2 years' duration (the shortest time frame that was valid to assess the type of disease response) were examined. All the patients underwent adequate physical, instrumental, laboratory, and psychiatric examinations, during which the type of COPD response was determined. Before a rehabilitation cycle, after its termination, and 1, 3, and 6 months later, each patient underwent evaluation of the symptoms of COPD, the frequency of its exacerbations, the level of basic knowledge about COPD according to the author's questionnaire, assessment of the quality of life and the symptoms of anxiety and depression, and functional tests. RESULTS: The final sample included 30 patients who met the inclusion criteria and agreed to voluntarily participate in the PR programs. According to the type of a response to the underlying disease, the patients were divided into 2 polar groups: A) those who were anxious about their illness (excessive apprehension, fears that were associated with the perception of lung disease and that led to distress) and depression (despondency, an agonizing understanding of a possible poor outcome and consequences of the impact of COPD on their lives) and B) those who had a newly diagnosed type of COPD response - hyponosognosia (underestimation of disease severity, perception of the symptoms of COPD as age-related changes, and preservation of the old way of life to the detriment of their health). Effective personalized PR programs were elaborated and applied to both groups. CONCLUSION: Group measures focused on learning how to cope with the disease and its symptoms and on the ability to distinguish its manifestations from the signs of psychological distress and to combat them are effective in patients who are anxious about the disease and depressed (Group A). Individual inpatient activities aimed at the formation and maintenance of motivation, the formation of an image of the disease and its manifestations, and early specialized care for smoking cessation are indicated for patients with hyponosognosia (Group B).
[Mh] Termos MeSH primário: Sintomas Comportamentais
Assistência Centrada no Paciente
Doença Pulmonar Obstrutiva Crônica/reabilitação
Qualidade de Vida
Abandono do Hábito de Fumar
[Mh] Termos MeSH secundário: Adulto
Idoso
Sintomas Comportamentais/diagnóstico
Sintomas Comportamentais/fisiopatologia
Sintomas Comportamentais/terapia
Feminino
Seres Humanos
Masculino
Meia-Idade
Motivação
Assistência Centrada no Paciente/métodos
Assistência Centrada no Paciente/organização & administração
Desenvolvimento de Programas
Doença Pulmonar Obstrutiva Crônica/diagnóstico
Doença Pulmonar Obstrutiva Crônica/psicologia
Testes de Função Respiratória/métodos
Federação Russa
Abandono do Hábito de Fumar/métodos
Abandono do Hábito de Fumar/psicologia
Inquéritos e Questionários
Exacerbação dos Sintomas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE
[do] DOI:10.17116/terarkh201789318-23


  7 / 2151 MEDLINE  
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[PMID]:28254594
[Au] Autor:Perrine K; Helcer J; Tsiouris AJ; Pisapia DJ; Stieg P
[Ad] Endereço:Department of Neurological Surgery, Weill Cornell Medical College, New York, USA. Electronic address: krp2003@med.cornell.edu.
[Ti] Título:The Current Status of Research on Chronic Traumatic Encephalopathy.
[So] Source:World Neurosurg;102:533-544, 2017 Jun.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Chronic traumatic encephalopathy (CTE) evolved from the term dementia pugilistica describing the dementia found in many boxers to its current use in describing the dementia and depression sometimes found in athletes subjected to multiple concussions or subconcussive blows to the head. Concurrently, the neuropathology evolved to specify a unique type of tauopathy found in perivascular spaces at the depth of sulci and other features not typically seen in neurodegenerative tauopathies. Four stages of CTE have been proposed, with 4 corresponding clinical syndromes of traumatic encephalopathy syndrome. However, it remains unclear whether this is a syndrome unique to repetitive head trauma, especially in contact sports, because the epidemiology has been difficult to establish. In particular, research to date has had a denominator problem in not establishing the total number of potential cases at risk for developing CTE. The current review examines the evidence to date for these syndromes and contributing or complicating factors affecting the neuropathology, neuroimaging, and clinical presentations associated with them.
[Mh] Termos MeSH primário: Pesquisa Biomédica/tendências
Encefalopatia Traumática Crônica/patologia
[Mh] Termos MeSH secundário: Traumatismos em Atletas/etiologia
Traumatismos em Atletas/patologia
Sintomas Comportamentais/etiologia
Biomarcadores/metabolismo
Boxe/lesões
Concussão Encefálica/etiologia
Concussão Encefálica/patologia
Encefalopatia Traumática Crônica/etiologia
Transtornos Cognitivos/etiologia
Traumatismos Craniocerebrais/etiologia
Traumatismos Craniocerebrais/patologia
Seres Humanos
Tamanho do Órgão
Congêneres da Testosterona/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers); 0 (Testosterone Congeners)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE


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[PMID]:28186381
[Au] Autor:Bulbena A; Baeza-Velasco C; Bulbena-Cabré A; Pailhez G; Critchley H; Chopra P; Mallorquí-Bagué N; Frank C; Porges S
[Ti] Título:Psychiatric and psychological aspects in the Ehlers-Danlos syndromes.
[So] Source:Am J Med Genet C Semin Med Genet;175(1):237-245, 2017 Mar.
[Is] ISSN:1552-4876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There is increasing amount of evidence pointing toward a high prevalence of psychiatric conditions among individuals with hypermobile type of Ehlers-Danlos syndrome (JHS/hEDS). A literature review confirms a strong association between anxiety disorders and JHSh/hEDS, and there is also limited but growing evidence that JHSh/hEDS is also associated with depression, eating, and neuro-developmental disorders as well as alcohol and tobacco misuse. The underlying mechanisms behind this association include genetic risks, autonomic nervous system dysfunction, increased exteroceptive and interoceptive mechanisms and decreased proprioception. Recent neuroimaging studies have also shown an increase response in emotion processing brain areas which could explain the high affective reactivity seen in JHS/hEDS. Management of these patients should include psychiatric and psychological approaches, not only to relieve the clinical conditions but also to improve abilities to cope through proper drug treatment, psychotherapy, and psychological rehabilitation adequately coupled with modern physiotherapy. A multidimensional approach to this "neuroconnective phenotype" should be implemented to ensure proper assessment and to guide for more specific treatments. Future lines of research should further explore the full dimension of the psychopathology associated with JHS/hEDS to define the nature of the relationship. © 2017 Wiley Periodicals, Inc.
[Mh] Termos MeSH primário: Síndrome de Ehlers-Danlos/psicologia
[Mh] Termos MeSH secundário: Transtornos de Ansiedade/terapia
Sintomas Comportamentais/terapia
Seres Humanos
Transtornos Mentais/terapia
Guias de Prática Clínica como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170211
[St] Status:MEDLINE
[do] DOI:10.1002/ajmg.c.31544


  9 / 2151 MEDLINE  
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[PMID]:28181675
[Au] Autor:van Die MD; Williams SG; Emery J; Bone KM; Taylor JM; Lusk E; Pirotta MV
[Ad] Endereço:Department of General Practice, University of Melbourne, Parkville, Victoria, Australia.
[Ti] Título:A Placebo-Controlled Double-Blinded Randomized Pilot Study of Combination Phytotherapy in Biochemically Recurrent Prostate Cancer.
[So] Source:Prostate;77(7):765-775, 2017 May.
[Is] ISSN:1097-0045
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Men with biochemical recurrence of prostate cancer following local therapies often use natural supplements in an attempt to delay metastases and/or avoid the need for more aggressive treatments with undesirable side-effects. While there is a growing body of research into phytotherapeutic agents in this cohort, with some promising results, as yet no definitive recommendations can be made. This pilot study was undertaken to assess the feasibility of a fully-powered study to examine the effects of this phytotherapeutic intervention (containing turmeric, resveratrol, green tea and broccoli sprouts) on PSA doubling time in men with biochemical recurrence with a moderate PSA rise rate. METHODS: A double blind, randomized, placebo-controlled parallel trial was conducted with 22 men with biochemically recurrent prostate cancer and a moderate rise rate (PSA doubling time of 4-15 months and no evidence of metastases from conventional imaging methods). Patients were randomized to either the active treatment arm or placebo for 12 weeks. The primary endpoints were feasibility of study recruitment and procedures, and measurement of proposed secondary endpoints (prostate symptoms, quality of life, anxiety, and depression as measured on the EORTC QLQ-C30 and PR-25, the IPSS and HADS). Data were collected to estimate PSA-log slopes and PSA-doubling times, using a mixed model, for both the pre-intervention and post-intervention periods. RESULTS: Adherence to study protocol was excellent, and the phytotherapeutic intervention was well-tolerated, with similar numbers of mild-to-moderate adverse events in the active and placebo arms. Both the intervention and data collection methods were acceptable to participants. No statistical difference between groups on clinical outcomes was expected in this pilot study. There was between-subject variation in the PSA post treatment, but on average the active treatment group experienced a non-significant increase in the log-slope of PSA (pre-treatment doubling time = 10.2 months, post-treatment doubling time = 5.5 months), and the placebo group experienced no change in the log-slope of PSA (pre-treatment doubling time = 10.8 months, post-treatment doubling time = 10.9 months). CONCLUSION: The findings suggest that a fully powered study of this combination is feasible in men with biochemically recurrent prostate cancer and a moderate PSA rise rate. Prostate 77:765-775, 2017. © 2017 Wiley Periodicals, Inc.
[Mh] Termos MeSH primário: Brassica
Curcuma
Recidiva Local de Neoplasia
Antígeno Prostático Específico/sangue
Neoplasias da Próstata
Qualidade de Vida
Estilbenos
Chá
[Mh] Termos MeSH secundário: Idoso
Antineoplásicos Fitogênicos/administração & dosagem
Antineoplásicos Fitogênicos/efeitos adversos
Sintomas Comportamentais/diagnóstico
Sintomas Comportamentais/etiologia
Biomarcadores Tumorais/sangue
Seres Humanos
Masculino
Meia-Idade
Recidiva Local de Neoplasia/sangue
Recidiva Local de Neoplasia/psicologia
Prostatectomia/efeitos adversos
Neoplasias da Próstata/patologia
Neoplasias da Próstata/psicologia
Neoplasias da Próstata/terapia
Radioterapia/efeitos adversos
Estilbenos/administração & dosagem
Estilbenos/efeitos adversos
Avaliação de Sintomas/métodos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antineoplastic Agents, Phytogenic); 0 (Biomarkers, Tumor); 0 (Stilbenes); 0 (Tea); EC 3.4.21.77 (Prostate-Specific Antigen); Q369O8926L (resveratrol)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170720
[Lr] Data última revisão:
170720
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170210
[St] Status:MEDLINE
[do] DOI:10.1002/pros.23317


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[PMID]:28168595
[Au] Autor:Quigley J
[Ad] Endereço:Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, SPC 5766, Ann Arbor, MI, 48109-2700, USA. joannaq@med.umich.edu.
[Ti] Título:Juvenile Huntington's Disease: Diagnostic and Treatment Considerations for the Psychiatrist.
[So] Source:Curr Psychiatry Rep;19(2):9, 2017 Feb.
[Is] ISSN:1535-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Juvenile Huntington's disease (JHD) is a neurodegenerative disease with onset prior to the age of 21. While it accounts for a relatively small proportion of Huntington's disease (HD) diagnoses, its impact is significant on the quality of life for those affected. Clinicians may be unaware that HD can present in childhood and adolescence, delaying diagnosis. HD develops due to an expanded CAG repeat in the huntington gene. Rigidity, dystonia, and seizures are more common in JHD. Cognitive changes such as executive function impairments and decline in school performance are common. The burden of psychiatric symptoms is considerable and includes depression, anxiety, impulsivity, and aggression. While novel approaches to treatment interventions are investigated, current care is limited to targeting symptoms rather than disease modification. Prompt diagnosis and symptomatic treatment can maximize quality of life for these patients.
[Mh] Termos MeSH primário: Doença de Huntington/diagnóstico
Doença de Huntington/terapia
Psiquiatria
[Mh] Termos MeSH secundário: Adolescente
Sintomas Comportamentais/diagnóstico
Sintomas Comportamentais/psicologia
Sintomas Comportamentais/terapia
Criança
Transtornos Cognitivos/diagnóstico
Transtornos Cognitivos/psicologia
Transtornos Cognitivos/terapia
Diagnóstico Tardio
Intervenção Médica Precoce
Seres Humanos
Doença de Huntington/psicologia
Transtornos Mentais/diagnóstico
Transtornos Mentais/psicologia
Transtornos Mentais/terapia
Qualidade de Vida/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE
[do] DOI:10.1007/s11920-017-0759-9



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